Giant cystic craniopharyngiomas

Young, Shannan; Zimmerman, Robert A.; Nowell, M A; Bilaniuk, Larissa T.; Hackney, D. B.; Grossman, Robert I.; Goldberg, Herbert I.

doi:10.1007/bf00341745

Cited by 55 publications

(9 citation statements)

References 24 publications

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“…Rare cases of "giant" tumors with diameter up to 12 cm have been also described (117). Notably, in a series of 45 patients, no significant difference in the tumor volume was found among subjects older than 20 yr or younger than 20 yr (43).…”

Section: Imaging Featuresmentioning

confidence: 94%

Craniopharyngiomas

et al. 2006

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Craniopharyngiomas are rare, mainly sellar/parasellar, epithelial tumors diagnosed during childhood or adult life. Histologically, two primary subtypes have been recognized (adamantinomatous and papillary) with an as yet, unclarified pathogenesis. They may present with a variety of manifestations (neurological, visual, and hypothalamo-pituitary). Despite their benign histological appearance, they often show an unpredictable growth pattern, which, combined with the lack of randomized studies, poses significant difficulties in the establishment of an optimal therapeutic protocol. This should focus on the prevention of recurrence(s), improvement of survival, reduction of the significant disease and treatment-related morbidity (endocrine, visual, hypothalamic, neurobehavioral, and cognitive), and preservation of the quality of life. Currently, surgical excision followed by external beam irradiation, in cases of residual tumor, is the main treatment option. Intracystic irradiation or bleomycin, stereotactic radiosurgery, or radiotherapy and systemic chemotherapy are alternative approaches; their place in the management plan remains to be assessed in adequately powered long-term trials. Apart from the type of treatment, the identification of clinical and imaging parameters that will predict patients with a better prognosis is difficult. The central registration of patients with these challenging tumors may provide correlates between treatments and outcomes and establish prognostic factors at the pathological or molecular level that may further guide us in the future.

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Section: Imaging Featuresmentioning

confidence: 94%

Craniopharyngiomas

et al. 2006

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“…34 In this study, we reviewed the treatment effects of isotope interstitial radiotherapy in a relatively larger number of cases of giant posterior fossa cystic craniopharyngiomas. 3,6,9,11,18,28,35 The treatment options for giant posterior fossa cystic craniopharyngiomas also remain controversial. Due to the benign pathological nature of these tumors, resection should be the ideal choice, and several groups have recently achieved good results.…”

Section: Discussionmentioning

confidence: 99%

Interstitial radiotherapy using phosphorus-32 for giant posterior fossa cystic craniopharyngiomas

Zhang

Liu

et al. 2015

PED

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OBJECT The treatment for giant posterior fossa cystic craniopharyngiomas remains an important challenge in neurosurgery. The authors evaluated the effects of treating 20 patients with giant posterior fossa cystic craniopharyngiomas using phosphorus-32 (P-32) interstitial radiotherapy at their hospital. METHODS The patients included 11 boys and 9 girls with an age range of 3 to 168 months. Before treatment, the tumor volumes ranged from 65 to 215 ml. The intracranial pressure was increased in 16 patients, and optic nerve damage had occurred in 18. The patients received P-32 interstitial radiotherapy following stereotactic cyst-fluid aspiration or drainage and were followed up for 7–138 months. RESULTS The treatment immediately relieved the intracranial hypertension symptoms in all patients. At the end of follow-up, imaging examinations revealed that the cystic tumors had disappeared, but some residual calcification remained in 12 patients, and had decreased by more than 75% of the initial volume in 8 patients. The damaged optic nerve recovered in 3 cases, improved in 12 cases, remained unchanged in 1 case, and was aggravated in 2 cases. No other severe complications related to surgery or interstitial radiation occurred. During the follow-up period, 7 new cysts appeared in 5 patients who had received additional interstitial radiotherapies with a dose of P-32 that was calculated using the same formula as for the initial treatment. The new tumors then disappeared in 2 patients, significantly shrank in 2 patients, and progressed in 1 patient. CONCLUSIONS For treating giant posterior fossa cystic craniopharyngiomas, P-32 interstitial radiation after stereotactic cyst-fluid aspiration or drainage can achieve a high tumor control rate and has relatively satisfactory clinical effects and quality of life outcomes with few complications.

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“…The differential diagnosis of a suprasellar mass in childhood includes craniopharyngioma, astrocytoma of chiasmatic or hypothalamic origin, teratoma, dermoid cyst, germinoma and primitive neuroectodermal tumour [3,[8][9][10]. The treatment of pituitary tumours with suprasellar extension is usually performed nowadays through the transsphenoidal approach [11,12].…”

Section: Discussionmentioning

confidence: 99%

Cushing's disease due to a giant pituitary adenoma in early infancy: CT and MRI features

et al. 1996

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We report the case of a 12-month-old girl presenting with diabetes insipidus and Cushing s disease. Brain magnetic resonance imaging (MRI) demonstrated a large tumour arising from the sella turcica, extending up to the foramen of Monro and invading the cavernous sinuses. Surgery was performed to remove the suprasellar part of the tumour, and histology revealed an adrenocorticotrophin (ACTH) secreting pituitary adenoma. This entity is very rare in this age group and the MRI features have not previously been described.

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Giant cystic craniopharyngiomas

Cited by 55 publications

References 24 publications

Craniopharyngiomas

Craniopharyngiomas

Interstitial radiotherapy using phosphorus-32 for giant posterior fossa cystic craniopharyngiomas

Cushing's disease due to a giant pituitary adenoma in early infancy: CT and MRI features

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